Persistent prosopagnosia after COVID-19 Summary COVID-19 can cause neuropsychological problems including loss of smell and taste, long-lasting memory, speech and language problems, and psychosis. Here, we provide the first report of prosopagnosia following symptoms consistent with COVID-19. Annie is a 28-year-old woman who had normal facial recognition before contracting COVID-19 in March 2020. Two months later, she noticed facial recognition difficulties as she experienced symptom relapses and her impairments with faces persisted. On two familiar face recognition tests and two unfamiliar face recognition tests, Annie showed clear deficits. In contrast, she scored normal on tests assessing face detection, face identity perception, object recognition, scene recognition, and non-visual memory. Navigation deficits frequently coexist with prosopagnosia, and Annie reports that her navigation skills are substantially worse than hers before she became ill. Self-report survey data from 54 respondents with long COVID showed that the majority reported reductions in visual recognition and navigation skills. In summary, Annie’s results indicate that COVID-19 can produce severe and selective neuropsychological impairment similar to deficits seen after brain damage, and it appears that high-level visual impairments are not uncommon in people with long COVID . |
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COVID-19 may cause difficulty recognizing faces and navigation problems, according to a new Dartmouth study in Cortex .
While it is widely known that COVID-19 can cause a variety of neurological problems, including loss of smell and taste, and impairments in attention, memory, speech and language, known as "brain fog." ", the study is the first to report “prosopagnosia”, also known as face blindness, after symptoms compatible with COVID-19.
Researchers worked with Annie, a 28-year-old customer service representative and part-time portrait photographer, who was diagnosed with COVID-19 in March 2020 and suffered a relapse of symptoms two months later. Shortly after the relapse, Annie noticed difficulties with facial recognition and navigation.
“When I first met Annie, she told me that she couldn’t recognize her family’s faces,” says lead author Marie-Luise Kieseler, a graduate student in the department of psychology and brain sciences and a member of the Social Perception Laboratory. at Dartmouth. Annie recounted the time she was at a restaurant meeting her family for the first time after having COVID-19. She didn’t recognize them, and when she passed them again, her father called out to her. “It was like my dad’s voice was coming out of a stranger’s face,” says Annie, who now relies on voices to recognize people she meets.
Annie also experienced navigational impairments after having COVID-19. She has had difficulty remembering where particular sections of her grocery store are and she relies on Google maps and her bookmark feature to remember where she parks her car.
"The combination of prosopagnosia and navigation deficits that Annie had is something that caught our attention because the two deficits often go hand in hand after someone has had brain damage or developmental deficits," says lead author Brad Duchaine, professor of psychology and brain sciences and principal investigator of the Social Perception Laboratory at Dartmouth. "That coexistence is probably because the two skills depend on neighboring brain regions in the temporal lobe ."
The research team conducted a series of tests with Annie to assess her problems with facial recognition and determine whether she also has difficulties with other perceptual or cognitive skills.
Recognizing familiar faces and learning the identities of unfamiliar faces was especially difficult for Annie. For one of the tests, Annie was sequentially presented with 60 images of celebrity faces and asked to name them. Afterwards, she was presented with a list of celebrities appearing in the test to see if she knew them. Annie correctly identified 29% of the 48 celebrities she was familiar with compared to most people, who can correctly identify 84% of well-known celebrities.
The second test was a doppelganger test. Annie was shown the name of a celebrity and then presented with images of two faces: the face of a celebrity and that of someone similar, and then asked to identify which face was the famous person. She identified the celebrity in 69% of the 58 trials, compared to 87% in the control group.
Annie’s more limited ability to learn and then recognize unfamiliar faces was demonstrated by the Cambridge Face Memory Test. In the test, participants learn six faces of men and are then asked to discriminate between the learned faces and other faces. On average, people can usually identify 80% correctly, while Annie could only correctly identify 56%.
“Our results from the test with unfamiliar faces show that it wasn’t just that Annie couldn’t remember the name or biographical information of a famous person she was familiar with, but that she actually had trouble learning new identities ,” says Kieseler.
Her scores on the face detection, face identity perception, and object recognition tests were normal, indicating, respectively, that Annie’s problems with faces are due to deficiencies in memory for faces and are not a more general impediment.
Annie scored impeccably on the scene processing tests. When she was shown one set of landscapes and then shown them again with a new set, she made no errors in identifying the landscapes she had been shown previously. "It is likely, therefore, that her navigation problems are the result of processes that could contribute to the cognitive representation of the map rather than scene recognition deficits," Kieseler says.
“This type of dissociation like what we’re seeing in Annie is seen in some people who have navigation deficits, where they can recognize where they are, but when asked where else is in relation to where they are now, they struggle, Duchaine says. “They have trouble understanding the relationships between different places, which is a step beyond recognizing the place you are in.”
Annie also did very well on speech recognition tests compared to controls, so researchers believe her problems with face processing are primarily due to a deficit in the visual system.
“It is known that COVID-19 can cause broad cognitive problems, but here we are seeing severe and highly selective problems in Annie,” Duchaine says, “and that suggests that there could be many other people who have quite severe and selective deficits after COVID ”.
To determine whether others have experienced problems with perception, recognition, and navigation due to long COVID, the research team obtained self-reported data from 54 people who had long COVID with symptoms for 12 weeks or more; and 32 people who reported that they had fully recovered from COVID-19.
Respondents were asked to rate themselves on statements about their visual perception and cognitive functioning, such as whether they could track characters on television or navigate their environment, before and after they contracted COVID-19. The research team measured the change in scores before and after and compared the results of the long COVID group to those of the fully recovered COVID group.
“The majority of respondents with long COVID reported that their cognitive and perceptual abilities had declined since they had COVID, which was not surprising, but what was really fascinating was the number of respondents who reported deficits,” Kieseler says. “It wasn’t just a small concentration of really deteriorating cases, but a vast majority of people in the long COVID group reported notable difficulty doing things they could do before contracting COVID-19 without any problems.”
“One of the challenges that many respondents reported was difficulty visualizing family and friends , which is something we often hear from prosopagnosics,” says Duchaine, co-founder of faceblind.org.
“Our study highlights the types of perceptual problems with facial recognition and navigation that COVID-19 can cause; It is something that people should be aware of, especially doctors and other health professionals.”
Duchaine says, "To our knowledge, no one has measured the types of high-level visual processing skills that are affected by COVID-19 that we focus on here in this paper, so if it’s happening in the visual system, "These are likely selective deficits because problems in other areas of the brain are also occurring in some people."
